Actigraphy to Measure Physical Activity in the Intensive Care Unit: A Systematic Review

Kristin E. Schwab, An Q. To, Jennifer Chang, Bonnie Ronish, Dale Needham, Jennifer L. Martin, Biren B. Kamdar

Research output: Contribution to journalReview article

Abstract

Objective: In the intensive care unit (ICU), prolonged inactivity is common, increasing patients’ risk for adverse outcomes, including ICU-acquired weakness. Hence, interventions to minimize inactivity are gaining popularity, highlighting actigraphy, a measure of activity involving a wristwatch-like accelerometer, as a method to inform these efforts. Therefore, we performed a systematic review of studies that used actigraphy to measure patient activity in the ICU setting. Data Sources: We searched PubMed, EMBASE, CINAHL, Cochrane Library, and ProQuest from inception until December 2016. Study Selection: Two reviewers independently screened studies for inclusion. A study was eligible for inclusion if it was published in a peer-reviewed journal and used actigraphy to measure activity in ≥5 ICU patients. Data Extraction: Two reviewers independently performed data abstraction and risk of bias assessment. Abstracted actigraphy-based activity data included total activity time and activity counts. Results: Of 16 studies (607 ICU patients) identified, 14 (88%) were observational, 2 (12%) were randomized control trials, and 5 (31%) were published after 2009. Mean patient activity levels per 15 to 60 second epoch ranged from 25 to 37 daytime and 2 to 19 nighttime movements. Actigraphy was evaluated in the context of ICU and post-ICU outcomes in 11 (69%) and 5 (31%) studies, respectively, and demonstrated potential associations between actigraphy-based activity levels and delirium, sedation, pain, anxiety, time to extubation, and length of stay. Conclusion: Actigraphy has demonstrated that patients are profoundly inactive in the ICU with actigraphy-based activity levels potentially associated with important measures, such as delirium, sedation, and length of stay. Larger and more rigorous studies are needed to further evaluate these associations and the overall utility of actigraphy in the ICU setting.

Original languageEnglish (US)
JournalJournal of Intensive Care Medicine
DOIs
StateAccepted/In press - Jan 1 2019

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Actigraphy
Intensive Care Units
Exercise
Delirium
Length of Stay
Information Storage and Retrieval
PubMed
Libraries
Anxiety
Pain

Keywords

  • accelerometry
  • actigraphy
  • critical care
  • intensive care units
  • physical activity

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Actigraphy to Measure Physical Activity in the Intensive Care Unit : A Systematic Review. / Schwab, Kristin E.; To, An Q.; Chang, Jennifer; Ronish, Bonnie; Needham, Dale; Martin, Jennifer L.; Kamdar, Biren B.

In: Journal of Intensive Care Medicine, 01.01.2019.

Research output: Contribution to journalReview article

Schwab, Kristin E. ; To, An Q. ; Chang, Jennifer ; Ronish, Bonnie ; Needham, Dale ; Martin, Jennifer L. ; Kamdar, Biren B. / Actigraphy to Measure Physical Activity in the Intensive Care Unit : A Systematic Review. In: Journal of Intensive Care Medicine. 2019.
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abstract = "Objective: In the intensive care unit (ICU), prolonged inactivity is common, increasing patients’ risk for adverse outcomes, including ICU-acquired weakness. Hence, interventions to minimize inactivity are gaining popularity, highlighting actigraphy, a measure of activity involving a wristwatch-like accelerometer, as a method to inform these efforts. Therefore, we performed a systematic review of studies that used actigraphy to measure patient activity in the ICU setting. Data Sources: We searched PubMed, EMBASE, CINAHL, Cochrane Library, and ProQuest from inception until December 2016. Study Selection: Two reviewers independently screened studies for inclusion. A study was eligible for inclusion if it was published in a peer-reviewed journal and used actigraphy to measure activity in ≥5 ICU patients. Data Extraction: Two reviewers independently performed data abstraction and risk of bias assessment. Abstracted actigraphy-based activity data included total activity time and activity counts. Results: Of 16 studies (607 ICU patients) identified, 14 (88{\%}) were observational, 2 (12{\%}) were randomized control trials, and 5 (31{\%}) were published after 2009. Mean patient activity levels per 15 to 60 second epoch ranged from 25 to 37 daytime and 2 to 19 nighttime movements. Actigraphy was evaluated in the context of ICU and post-ICU outcomes in 11 (69{\%}) and 5 (31{\%}) studies, respectively, and demonstrated potential associations between actigraphy-based activity levels and delirium, sedation, pain, anxiety, time to extubation, and length of stay. Conclusion: Actigraphy has demonstrated that patients are profoundly inactive in the ICU with actigraphy-based activity levels potentially associated with important measures, such as delirium, sedation, and length of stay. Larger and more rigorous studies are needed to further evaluate these associations and the overall utility of actigraphy in the ICU setting.",
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N2 - Objective: In the intensive care unit (ICU), prolonged inactivity is common, increasing patients’ risk for adverse outcomes, including ICU-acquired weakness. Hence, interventions to minimize inactivity are gaining popularity, highlighting actigraphy, a measure of activity involving a wristwatch-like accelerometer, as a method to inform these efforts. Therefore, we performed a systematic review of studies that used actigraphy to measure patient activity in the ICU setting. Data Sources: We searched PubMed, EMBASE, CINAHL, Cochrane Library, and ProQuest from inception until December 2016. Study Selection: Two reviewers independently screened studies for inclusion. A study was eligible for inclusion if it was published in a peer-reviewed journal and used actigraphy to measure activity in ≥5 ICU patients. Data Extraction: Two reviewers independently performed data abstraction and risk of bias assessment. Abstracted actigraphy-based activity data included total activity time and activity counts. Results: Of 16 studies (607 ICU patients) identified, 14 (88%) were observational, 2 (12%) were randomized control trials, and 5 (31%) were published after 2009. Mean patient activity levels per 15 to 60 second epoch ranged from 25 to 37 daytime and 2 to 19 nighttime movements. Actigraphy was evaluated in the context of ICU and post-ICU outcomes in 11 (69%) and 5 (31%) studies, respectively, and demonstrated potential associations between actigraphy-based activity levels and delirium, sedation, pain, anxiety, time to extubation, and length of stay. Conclusion: Actigraphy has demonstrated that patients are profoundly inactive in the ICU with actigraphy-based activity levels potentially associated with important measures, such as delirium, sedation, and length of stay. Larger and more rigorous studies are needed to further evaluate these associations and the overall utility of actigraphy in the ICU setting.

AB - Objective: In the intensive care unit (ICU), prolonged inactivity is common, increasing patients’ risk for adverse outcomes, including ICU-acquired weakness. Hence, interventions to minimize inactivity are gaining popularity, highlighting actigraphy, a measure of activity involving a wristwatch-like accelerometer, as a method to inform these efforts. Therefore, we performed a systematic review of studies that used actigraphy to measure patient activity in the ICU setting. Data Sources: We searched PubMed, EMBASE, CINAHL, Cochrane Library, and ProQuest from inception until December 2016. Study Selection: Two reviewers independently screened studies for inclusion. A study was eligible for inclusion if it was published in a peer-reviewed journal and used actigraphy to measure activity in ≥5 ICU patients. Data Extraction: Two reviewers independently performed data abstraction and risk of bias assessment. Abstracted actigraphy-based activity data included total activity time and activity counts. Results: Of 16 studies (607 ICU patients) identified, 14 (88%) were observational, 2 (12%) were randomized control trials, and 5 (31%) were published after 2009. Mean patient activity levels per 15 to 60 second epoch ranged from 25 to 37 daytime and 2 to 19 nighttime movements. Actigraphy was evaluated in the context of ICU and post-ICU outcomes in 11 (69%) and 5 (31%) studies, respectively, and demonstrated potential associations between actigraphy-based activity levels and delirium, sedation, pain, anxiety, time to extubation, and length of stay. Conclusion: Actigraphy has demonstrated that patients are profoundly inactive in the ICU with actigraphy-based activity levels potentially associated with important measures, such as delirium, sedation, and length of stay. Larger and more rigorous studies are needed to further evaluate these associations and the overall utility of actigraphy in the ICU setting.

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